Development and Usefulness of Institutional Decision Support Protocol for Pharmacists Replying Prescription Queries by Community Pharmacists

Abstract

Prescription queries are essential for appropriate pharmacotherapy even though they impose additional work upon healthcare providers and increase the waiting time for out-patients. We developed a 10-item institutional decision support protocol that enables pharmacists in our hospital to change out-patient prescriptions when prescription queries were provided from community pharmacies. All prescription queries from community pharmacies were managed by pharmacists in our hospital. If the prescription queries fit the protocol, hospital pharmacists would assess the prescriptions based on drug information and other available information from the electronic medical record system. These pharmacists then replied that the prescriptions could be changed and provided information to physicians about the revised prescriptions. To evaluate the protocol, we analyzed the records of prescription queries from community pharmacies regarding out-patient prescriptions both before and after 4 weeks developing the protocol. After protocol development, 17.9％ (88/492) of prescription queries were changed by hospital pharmacists based on the protocol. The ratio of prescription queries requiring more than 10 minutes to complete was markedly reduced from 13.5％ (10/74) to 0％ (0/71). The majority (76.6％, 85/111) of community pharmacies that provided prescription queries were located 6 km or more from our hospital. These results suggest that our institutional decision support protocol was useful in reducing the workload for pharmacists and physicians, as well as decreasing waiting times for out-patients, without disturbing the effectiveness and safety of pharmacotherapy. In addition, this protocol-based pharmacotherapy management was applicable to prescription queries from community pharmacies located over a wide area.